Sustaining general practice in challenging environments

224 views
154 views

Published on

rpas

0 Comments
0 Likes
Statistics
Notes
  • Be the first to comment

  • Be the first to like this

No Downloads
Views
Total views
224
On SlideShare
0
From Embeds
0
Number of Embeds
18
Actions
Shares
0
Downloads
0
Comments
0
Likes
0
Embeds 0
No embeds

No notes for slide

Sustaining general practice in challenging environments

  1. 1. Sustaining General Practicein Challenging Environments Remote and Rural Perspective By Dr Susan Taylor
  2. 2. Remote and Rural General Practice is Different Historical Background Innovative Solutions may help urban problems Remote and Rural Medicine is a speciality
  3. 3. Recent Publications BMA – Healthcare in a Rural Setting Building and Health Service Fit for the Future(Professor David Kerr) Delivering for Health – Scottish Executive 2005
  4. 4. Centre for Rural Health – www.abdn.ac.uk/crh  Clinical Peripherality Index – from 0-100  Based on :-  Population Density  Something  Drive time to Consultant hospital  Drive time to Health Board Headquarters
  5. 5.  Geography Population Density Generalist Skills Required Dispensing – new Pharmacy Contract with no clear plan for Dispensing Doctors
  6. 6. Recruitment and Retention 1 Retain current practitioners- Stable contract- Ability to maintain skills ( BASICS, ATLS etc)- Adequate backfill staff- eg Associate GPs- OOH opt out or adequate pay and support to continue on-call- Reduce practice management burdens
  7. 7. Recruitment and Retention 2 Recruit New Staff- Training issues with new MMC structures- Need to target all areas of training:- Prior to medical school – support mentoring schemes to help rural pupils into Medical School2 Bring medical students to remote practices3 Get Remote 1y care involved with FY training4 Give GP registrars access to remote General Practice5 Enhance Rural Fellowship schemes for post-Registrar experience
  8. 8. Recruitment and Retention 3 Non GP staff Issues around skill mix, community nursing vs practice nursing, lack of professional practice management skills, ambulance provision
  9. 9. Contract Issues New GMSMany remote GPs highly dependent on MPIGMinimal outside earning capacityQOF and Enhanced Service payments capitation ledDispensing Income not reliableHistorical need to subsidise remote and rural populations Salaried and Section 17 C options variable and may not be sustainable
  10. 10. Social Issues Increasing population in Highlands and Islands Aging population GPs increase stability of communities ( CRH research) Collaberation with social services over respite care, availability of home carers, access to affordable housing

×